Bill Would Prevent Over-Prescribing

A California bill would require doctors to check California’s prescription drug database before prescribing opiates. The Controlled Substance Utilization Review and Evaluation System (CURES) is the nation’s most advanced prescription drug monitoring program, but just 35% of California providers and dispensers use it. Carmen Balber, executive director of Consumer Watchdogs said, “California loses 4,500 people a year to preventable drug overdoses–more than any other state….The legislature can help…by requiring doctors to check the prescription database before recommending patients take the most dangerous and addictive drugs. It’s clear that making use of the database voluntary does not work.”

SB 482, by California state Senator Ricardo Lara, would require doctors to check California’s CURES database when prescribing Schedule II or III drugs like Oxycontin to a patient for the first time, and annually thereafter if the treatment continues. The Centers for Disease Control and Prevention issued new prescribing guidelines that recommend doctors use prescription drug databases every time they prescribe an opioid. Last month, president Obama proposed $1.2 billion in new federal funding to fight opioid abuse, including funds to expand the use of state prescription drug databases.

Twenty-two states mandate use of a state prescription database. States that track results have seen reduced doctor-shopping and lower opioid prescription rates. Also doctors say that the databases are useful to them in prescribing the right medications. The following states have seen improvements after mandating the use of a database:

  • New York saw a 75% drop in patients seeing multiple prescribers for the same drugs.
  • Kentucky found that opioid prescriptions to doctor-shopping individuals fell 54%. Also, overdose-related deaths declined for the first time in six years in 2013.
  • Tennessee saw a 36% drop in patients who were seeing multiple prescribers to get the same drugs. Tennessee prescribers say they are 41% less likely to prescribe controlled substances after checking the database, and 34% more likely to refer a patient for substance abuse treatment. Also, 86% of prescribers say the database is useful for decreasing doctor shopping.

Washington State Comes Out Ahead with its Health Exchange

An article featured in www.politico.com looks at how well state exchanges are running. On the Obamacare racetrack, Washington, Kentucky, and New York are leading the pack. Relatively free of the technical problems that have plagued the federally run insurance exchanges, some states are charging ahead on enrollment while others have run up against roadblocks.

The leader on enrollments, so far is Washington state, with nearly 49,000 enrollees in exchange plans and Medicaid. The state has been a leader in setting up its exchange all along, and officials say the swell of enrollments has allowed them to identify the biggest website problems early on.

“The problems have ranged from error codes to difficulties reconciling state tax records with the federal government,” said Washington exchange spokesman Michael Marchand. Those problems are being fixed through regular overnight weekend maintenance, which will most likely continue through the beginning of December, he said.

Enrollment is also humming along in New York and Kentucky. More than 37,000 have enrolled in N.Y. State of Health and 31,500 have signed up through Kynect, the Kentucky exchange. It’s moving a little slower in California, Colorado, and Connecticut, where the websites are basically working, but still experiencing some glitches, according to politico.com. In California, there have been delays in authorizing enrollment counselors, which has slowed down the process for some residents who want help in-person.

In some states, glitches have been so severe that officials have been forced to postpone deadlines. The Hawaii exchange opened two weeks late and  crashed when people started visiting it. But it’s been up and running since then. Vermont Gov. Peter Shumlin announced last week that residents can stay on their existing plans through March 31 because of the exchange’s technical problems. That exchange depended on the same lead contractor as the troubled federal one. Oregon’s exchange is still so spotty that Gov. John Kitzhaber urged residents to enroll using paper applications. Officials are not sure whether it will be fully operational by Dec. 15 – the deadline to sign up to be covered by Jan. 1. Oregon had embraced the president’s health law early and enthusiastically.

Tose watching the exchanges warn against scoring them too early, stressing that open enrollment lasts for another five months. For more information, visit http://www.politico.com/story/2013/11/state-health-care-exchanges-mixed-results-obamacare-affordable-care-act-99346.html#ixzz2kUNmlMn5

Last Updated 11/13/2019

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